Predictive study of fragmentation QRS waves dispersion of P wave and QT combined with serum NT-proBNP on heart failure in patients with acute myocardial infarction

DU Qian-qian; DU Chun-yan; MENG Chun

doi:10.3969/j.issn.1672-5301.2023.12.010

Abstract：Objective To explore the predictive value of fragmented QRS waves,P wave dispersion(Pd)and QT dispersion(QTd)combined with serum N-terminal pro brain natriuretic peptide(NT-proBNP)level in patients with acute myocardial infarction(AMI)complicated with heart failure.Methods The clinical data of 152 patients with AMI admitted to Anqiu People's Hospital from April 2019 to July 2020 were retrospectively analyzed.After admission,all the fragmented QRS complex,Pd,QTd and serum NT-proBNP level were detected.All the patients were followed up for 6 months,and the above indexes were compared between the patients with and without heart failure.The risk factors for heart failure in the patients with AMI and the predictive value of every index alone or combined for heart failure were analyzed.Results The incidence of heart failure was 26.97%.Age,smoking history,drinking history,hypertension,type 2 diabetes mellitus,hyperlipidemia,multivessel disease,proximal lesion,cardiac functionⅢ-Ⅳ,NLR,fragmented QRS waves,PD,QTd,serum NT-proBNP level,time from onset to recovery of blood supply were risk factors of AMI complicated with heart failure(OR=4.702,3.925,3.536,3.747,3.872,4.204,4.316,4.335,4.207,4.982,4.519,6.704,6.201,6.018,4.825,P<0.05).The specificity of fragmented QRS waves,PD and QTd combined with serum NT-proBNP level in predicting AMI complicated with heart failure were higher than those of single prediction(P<0.05),The AUC was also higher than those of single prediction(P<0.05).Conclusion The patients with AMI would have the fragmented QRS waves,prolonged Pd and QTd and elevated serum NT-proBNP,which would be,same as age,smoking history and drinking history,the risk factor for heart failure.The combination of the four would make ideal predictive effect on heart failure in the patients with AMI.